Each institute should aim for public participation that is sufficiently broad, that uses a selection process that is fair and that is perceived to be fair, and that incorporates representatives participants from disease-specific and other interest groups and who bring to the process the kind of knowledge, experience, and perspectives that are needed for the deliberation at hand.

The new organizational mechanisms for improving public input proposed here have the potential to increase, in the short term, organizational costs and complexity. In the long run, however, the committee believes that the contribution made by these offices and the Council will prove to be cost-effective in terms of carrying out NIH's mission to improve health through research and will contribute to overall goodwill on the part of the public and Congress toward NIH. Each entity—the Director's Council of Public Representatives, the network of Offices of Public Liaison, and the existing advisory bodies to the director of NIH and the institutes—has its own rationale and roles that should improve NIH's priority-setting process.